Archives of pediatrics & adolescent medicine
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Arch Pediatr Adolesc Med · May 2011
Associations between quality of primary care and health care use among children with special health care needs.
To determine whether parent-reported quality of primary care was associated with subsequent health care use for children with special health care needs. ⋯ Parent-reported, low-quality family centeredness was associated with higher rates of subsequent nonurgent emergency department visits and hospitalizations among children with special health care needs. These findings highlight family-centered care as a critical area for primary care intervention to reduce potentially preventable health care use.
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Arch Pediatr Adolesc Med · May 2011
Editorial Comment Comparative StudyThe hazards of drawing conclusions from before-and-after studies of system-level interventions: knowing may not be enough.
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Arch Pediatr Adolesc Med · May 2011
Comparative StudyClostridium difficile infection in hospitalized children in the United States.
To evaluate the trend in Clostridium difficile infection (CDI) among hospitalized children in the United States and to evaluate the severity of and risk factors associated with these cases of CDI. ⋯ There is an increasing trend in CDI among hospitalized children, and this disease is having a significant effect on these children. In contrast to adults, there is no increasing trend in the severity of CDI in children. Children with medical conditions (including inflammatory bowel disease and immunosuppression) or conditions requiring antibiotic administration are at high risk of CDI.
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Arch Pediatr Adolesc Med · May 2011
Comparative StudyPutting guidelines into practice: improving documentation of pediatric asthma management using a decision-making tool.
To assess improvement in documentation of asthma indicators using the Asthma Toolbox, an asthma decision-making tool developed in accord with National Asthma Education and Prevention Program guidelines. ⋯ Use of the Asthma Toolbox, an asthma decision-making tool, significantly increased documentation of pediatric asthma management among providers working in high-disparity, urban primary care settings.
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Arch Pediatr Adolesc Med · May 2011
Comparative StudyReduction in hospital mortality over time in a hospital without a pediatric medical emergency team: limitations of before-and-after study designs.
To determine whether hospital mortality has decreased over time in a hospital that has not introduced a pediatric medical emergency team (PMET). ⋯ We found a reduction in hospital mortality over time in a children's hospital without a PMET. This demonstrates the limitation of before-and-after study designs, and we hypothesize that multiple co-interventions account for the decrease in mortality. Whether a PMET could have reduced mortality further is unknown.